中文摘要：

目的以胎儿四腔心容积为基础，通过后处理，与二维超声比较，探讨胎儿四维超声心动图在显示正常胎儿心脏和先天性心脏畸形胎儿中的临床应用。方法对108例孕妇行胎儿心脏四维超声检查，其中84例心脏正常、24例先天心脏畸形。显示胎儿四腔心切面后启动四维容积扫查获得心脏灰阶容积和彩色多普勒血流容积，将图像储存后进行后处理。获取容积与后处理由同一医师完成。利用上述容积显示如下结构：四腔心（4C）、左心室流出道（LVOT）、右心室流出道（RVOT）、三血管气管（3VT）、二尖瓣（MV）、三尖瓣（TV）、主动脉（AO）、肺动脉（MPA）、主动脉弓（ARCH）、动脉导管（DA）。比较正常胎儿孕周i〉28周和〈28周胎儿在不同四腔心初始位置下对同一结构显示率的差异。所有四维超声心动图的诊断结果与二维超声比较，其中11例先天心脏畸形经产后解剖或生后超声心动图证实。结果108例胎儿均获得心脏四维容积数据（100％）。每个对象扫查时问（7．53±2．37）min，5s／容积。四腔心与房室瓣显示率100％。除主动脉弓外，心脏正常胎儿孕周≥28周对上述心脏结构的显示率高于〈28周胎儿（P〈0．05）；除三血管气管切面外，心脏初始位置为心尖四腔心时对上述切面的显示率高于横位四腔心和心底四腔心（P〈0．05）。孕周与胎心初始位置对显示率有显著影响，孕周大、初始位置为心尖四腔心切面获取成功率较高。先天性心脏畸形胎儿24例，四维超声心动图在显示瓣膜、瓣环及心脏间隔上显示出优势。结论以四腔心为基础切面能够快速获取胎JL,5,脏容积，并能较为完整地评价胎JL,5,脏结构。胎儿四维超声心动图在显示复杂胎儿心脏异常中起到一定的作用。

英文摘要：

Objective The four chamber volume post processing was compared with two-dimension- al ultrasound. The objective of this study was to explore the clinical application of four-dimensional echocar- diography ultrasound in the detection of normal and abnormal fetal heart scanning. Methods One hundred and eight fetuses （ 84 healthy fetuses and 24 fetuses with fetal cardiac anomalies） took fetal echocardio- graphy. The four-dimensional volume scanning was started to obtain grayscale and color Doppler flow volume capacity based on four chamber view, and the image for post-processing was saved. Sampling and processingwere done by the same investigator. The following sections from above mentioned volume were used to show four chamber view（4C）, left ventricular outflow tract （LVOT）, right ventricular outflow tract （RVOT）, three vessel trachea （3VT）, mitral （ MV ）, tricuspid （ TV ）, main pulmonary artery （ MPA ）, cross-ties, aortic arch （ARCH）, and ductus arteriosus arch（DA）. The differences for the detection rate of the same cardiac struc- tures detected from different initiate four chamber views were compared healthy those of fetuses I〉28 weeks with those in 〈 28 weeks gestation age. All diagnosis of four-dimensional echocardiography were compared with two-dimensional ultrasound and 11 cases were confirmed by postnatal autopsy and echocardiography. Results All cases were obtained M＇fh four-dimensional volumes （100%）. The mean scanning time was 7.53 _＋ 2.37 min for each patient and 5 s for each volume. The rate of four chamber heart and the valve was 100%. In addition to the aortic arch, the detection rates in healthy fetuses i〉 28 weeks swas higher ~han those subject with the 〈 28 weeks gestation age （P 〈 0.05 ） ; In addition to the three vascular trachea view, the detection rates of the heart with the initiate position of the apical four-chamber were higher than transverse four-chamber heart and cardiac base four chamber （ P 〈 0.05）. The large gestationa